title: Individual common carotid artery wall layer dimensions, but not carotid intima-media thickness, indicate increased cardiovascular risk in women with preeclampsia: an investigation using noninvasive high-frequency ultrasound.
abstract: BACKGROUND
  Preeclampsia (PE) is associated with increased risk of cardiovascular disease later in life. Ultrasound assessment of the common carotid artery intima-media thickness (IMT) during or after PE has not indicated any increased cardiovascular risk.
  
  
  RESULTS
  We used high-frequency ultrasound (22 MHz) to estimate the individual common carotid artery IMTs in 55 women at PE diagnosis and in 64 women with normal pregnancies at a similar stage. All were re-examined about 1 year postpartum. A thick intima, thin media, and high intima/media (I/M) ratio are signs of a less healthy artery wall. PE was associated with a significantly thicker mean common carotid artery intima, thinner media, and higher I/M ratio than in normal pregnancy (mean I/M difference, 0.21; 95% confidence interval, 0.17-0.25; P<0.0001). After adjustment for first trimester body mass index and mean arterial pressure, differences in intima thickness and I/M remained significant. About 1 year postpartum, these values had improved in both groups, but group differences remained significant (all adjusted P<0.0001). There were no significant differences in IMT between groups. In receiver-operating characteristic curve analysis, intima thickness and I/M were strongly predictive of prevalent PE (area under the curve, ≈0.95), whereas IMT was not (area under the curve, 0.49).
  
  
  CONCLUSIONS
  The arteries of women with PE were negatively affected during pregnancy and 1 year postpartum compared with women with normal pregnancies, indicating increased cardiovascular risk. Estimation of intima thickness and I/M ratio seem preferable to estimation of common carotid artery IMT in imaging cardiovascular risk in PE. Results from this pilot study warrant further confirmation.
authors.affiliation: Department of Women's and Children's Health, Section for Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden.
authors.forename: Tansim
authors.initials: T
authors.lastname: Akhter
authors.forename: Anna-Karin
authors.initials: AK
authors.lastname: Wikström
authors.forename: Marita
authors.initials: M
authors.lastname: Larsson
authors.forename: Tord
authors.initials: T
authors.lastname: Naessen
mesh_terms: D000328:Adult; D019540:Area Under Curve; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016014:Linear Models; D010865:Pilot Projects; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011247:Pregnancy; D015995:Prevalence; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016216:Ultrasonography, Prenatal
keywords: cardiovascular diseases; carotid artery, common; carotid intima-media thickness; high-frequency ultrasound; intima/media ratio; preeclampsia; ultrasound